Abstract:This study detected an increased HR for subsequent stroke among Taiwanese UC patients hen compared to that among matched comparison patients without IBD.
“…40–45 Manually checking the reference lists of relevant articles yielded one additional article. Thus, a total of 27 articles 5,8–33 was included in the final analysis (Figure 1). Figure 1.References searched and selection of studies in the meta–analysis.…”
Section: Resultsmentioning
confidence: 99%
“…However, there are conflicting data as to whether IBDs increase risk for CVD incidence and mortality. Although some studies have indicated an increased risk of CVA, 8–13 CHD 11–15 and myocardial infarction (MI) 10 occurrences in patients with IBD, other studies did not detect such a significantly increased risk. 5,15–17 In addition, previous studies have reported conflicting results on the association between IBD and CVD mortality.…”
Background: The risk of cardiovascular disease occurrence and death in inflammatory bowel disease patients is still unclear. Design: Meta-analysis. Methods: Pertinent studies were identified by searching articles in PubMed and Web of Knowledge to December 2017 and reviewing the reference lists of the retrieved articles. We used the fixed-effect model to pool the study-specific estimates when there was no indication of heterogeneity; otherwise, the random-effect model was used. Results: A total of 27 articles was included, of which 11 studies reported the risk of cardiovascular disease incidence and 16 studies reported the risk of cardiovascular disease death. The pooled relative risks were 1.25 (95% confidence interval (CI): 1.08, 1.44), 1.17 (95% CI: 1.07, 1.27) and 1.12 (95% CI: 1.05, 1.21) for cerebrovascular disease, coronary heart disease and myocardial infarction, respectively. In particular, the pooled relative risk was much higher in females. The pooled standardized mortality ratios were 1.01 (95% CI: 0.90, 1.14) for Crohn's disease patients and 0.93 (95% CI: 0.86, 1.01) for ulcerative colitis patients with low heterogeneity across studies. No publication bias was detected. Conclusions: There was a positive association between inflammatory bowel disease and higher risk of cardiovascular disease incidence, particularly in females. Such an association was not observed for cardiovascular disease mortality.
“…40–45 Manually checking the reference lists of relevant articles yielded one additional article. Thus, a total of 27 articles 5,8–33 was included in the final analysis (Figure 1). Figure 1.References searched and selection of studies in the meta–analysis.…”
Section: Resultsmentioning
confidence: 99%
“…However, there are conflicting data as to whether IBDs increase risk for CVD incidence and mortality. Although some studies have indicated an increased risk of CVA, 8–13 CHD 11–15 and myocardial infarction (MI) 10 occurrences in patients with IBD, other studies did not detect such a significantly increased risk. 5,15–17 In addition, previous studies have reported conflicting results on the association between IBD and CVD mortality.…”
Background: The risk of cardiovascular disease occurrence and death in inflammatory bowel disease patients is still unclear. Design: Meta-analysis. Methods: Pertinent studies were identified by searching articles in PubMed and Web of Knowledge to December 2017 and reviewing the reference lists of the retrieved articles. We used the fixed-effect model to pool the study-specific estimates when there was no indication of heterogeneity; otherwise, the random-effect model was used. Results: A total of 27 articles was included, of which 11 studies reported the risk of cardiovascular disease incidence and 16 studies reported the risk of cardiovascular disease death. The pooled relative risks were 1.25 (95% confidence interval (CI): 1.08, 1.44), 1.17 (95% CI: 1.07, 1.27) and 1.12 (95% CI: 1.05, 1.21) for cerebrovascular disease, coronary heart disease and myocardial infarction, respectively. In particular, the pooled relative risk was much higher in females. The pooled standardized mortality ratios were 1.01 (95% CI: 0.90, 1.14) for Crohn's disease patients and 0.93 (95% CI: 0.86, 1.01) for ulcerative colitis patients with low heterogeneity across studies. No publication bias was detected. Conclusions: There was a positive association between inflammatory bowel disease and higher risk of cardiovascular disease incidence, particularly in females. Such an association was not observed for cardiovascular disease mortality.
“…Although in retrospect, our patient might have been excluded from the study, he would have likely been treated with either AI or SERM for his low T and infertility. The association between inflammatory bowel disease and venous thromboembolism (VTE) is well established [36][37][38][39][40][41][42][43][44][45][46]. SERMS and AIs have been used in millions of women with breast cancer since the early 2000's.…”
Aim
Clomiphene citrate (CC) and anastrozole (AZ) have been used off label to increase testosterone (T) in hypogonadal infertile men (HIM). Both medications have been shown to increase T with different effects on estradiol (E2) and T-to-E2 ratios. There are no reported randomized trials comparing CC and AZ to improve T levels in HIM. We aimed to establish equivalence of CC vs. AZ with respect to improvement in T levels in HIM.
Methods
We randomized 26 HIM (T less than 350 ng/dL and normal luteinizing hormone [LH]). Patients were randomized to CC (25 mg/day) or AZ (1 mg/day) for 12 weeks. Hormones assayed were total T, free T, E2, LH, follicle stimulating hormone (FSH), and sex hormone binding globulin (SHBG). Patient-reported outcomes were the International Index of Erectile Function, Erection Hardness Scale, and the Androgen Deficiency in the Aging Male questionnaires. Blood tests and questionnaires were recorded at baseline, 6 and 12 weeks. Semen analyses were performed at baseline and 12 weeks.
Results
T increased significantly from baseline in both groups at 6 and 12 weeks. There was a significantly larger increase in T and mean increase from baseline in CC vs. AZ (571 vs. 408 ng/dL, respectively). Whereas E-2 levels increased in the CC group, they decreased in the AZ group. Though both groups demonstrated an increase in T-to-E-2 ratio from baseline, statistic significance at 6 and 12 weeks was only achieved with AZ. Neither group demonstrated significant changes in seminal parameters or patient-reported outcomes.
Conclusions
We failed to demonstrate equivalence of CC vs. AZ. CC resulted in significantly higher T levels than AZ. AZ resulted in a significantly larger increase in T/E-2 ratio than CC. No significant differences between CC and AZ on seminal parameters or patient-reported outcomes were demonstrated.
“…Known risk factors for stroke are age, obesity, DM, high blood pressure, dyslipidemia, smoking, atrial brillation, and metabolic syndrome (MetS), and MetS was also shown to be associated with upper gastrointestinal diseases [14]. Several cohort studies have been performed on the association between stroke and gastrointestinal diseases, including gastroesophageal re ux disease and ulcerative colitis [15,16].…”
Background: Studies have reported that several gastrointestinal diseases increase the risk of stroke. We aimed to evaluate the risk of stroke in patients with peptic ulcer disease (PUD) using a national sample cohort from South Korea. Methods: We extracted data entered into the Korean National Health Insurance Service for patients with PUD (n = 129,531) and for 1:1 matched control participants (n = 129,531) and analyzed the risk of stroke using Cox proportional hazard model. Subgroup analyses were performed based on age and sex.Results: The rates of hemorrhagic and ischemic stroke were lower in the PUD group than in the control group. In a subgroup analysis according to age, the adjusted hazard ratios (HRs) of PUD for hemorrhagic and ischemic stroke were 0.76 (95% CI = 0.63-0.90) and 0.85 (95% CI = 0.73-0.98) in the < 50-year-old group and 0.72 (95% CI = 0.65-0.80) and 0.84 (95% CI = 0.80-0.89) in the ≥ 50-year-old group, respectively (each p < 0.05). In a subgroup analysis according to sex, the adjusted HRs of PUD were 0.71 (95% CI = 0.63-0.81) and 0.81 (95% CI = 0.5-0.87) in men and 0.75 (95% CI = 0.66-0.86) and 0.88 (95% CI = 0.82-0.95) in women, respectively (each p < 0.05).Conclusions: Our study concluded that PUD does not increase the risk of ischemic or hemorrhagic stroke regardless of age and sex.
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